[Radiographic diagnosis of distal fibula avulsion fractures: Comparison of ankle X-ray and three-dimensional reconstruction of CT].

OBJECTIVE: To investigate the difference in sensitivity between X-ray and three-dimensional reconstruction of computed tomography (3D-CT) for the diagnosis of distal fibular avulsion fracture, and the radiographic presentation of the ossicle. METHODS: From January to October 2018, 92 patients with distal fibular avulsion fracture were visited for surgical treatment in Department of Sports Medicine, Peking University Third Hospital, and 60 cases were finally enrolled according to the inclusion and exclusion criteria. Intraoperative detection was regarded as the gold standard, and the diagnostic sensitivity of preoperative ankle X-ray and 3D-CT for the distal fibular avulsion fractures was statistically determined. The ossicle maximum diameter as well as the degree of its displacement were also measured. On 3D-CT, the distance from the ossicle center point to the anterior fibular tuberosity (a), the distance to the fibular tip (b), and the a/b value was used to present the ossicle displacement. RESULTS: Among the 60 patients, 36 and the 52 patients were correctly detected by X-ray and 3D-CT, respectively, and the sensitivities was 60.0% and 86.7%, respectively (P=0.004). The mean diameter of the ossicle on X-ray and 3D-CT was (9.2±3.9) mm and (10.5±3.2) mm, respectively. The mean distance from the ossicle center to the anterior fibular tuberosity (a) was (17.5±3.6) mm and the mean distance to the fibular tip (b) was (17.4±4.8) mm, with mean a/b values of 1.1±0.7. The intraclass correlation coefficients (ICC) for each measurement ranged from 0.891-0.998 with a high degree of consistency. CONCLUSION: Compared with X-ray, 3D-CT has higher sensitivity in diagnosing distal fibular avulsion fractures, can help clinicians evaluate ossicle's location and choose surgical methods, and is recommended to be performed in patients with suspected distal fibula avulsion fractures in clinical practice.

[Investigation of serum surface active protein D and clara cell protein levels in workers exposed to silica dust in ferrous metal foundry].

Objective: To investigate the levels of serum surface active protein D (SP-D) and clara cell protein (CCl6) in workers exposed to black silica dust, and analyze its influencing factors. Methods: From July to September 2021, 174 workers in 37 positions exposed to silica dust in 5 ferrous metal foundry were investigated by cross-sectional research method. The exposure concentration of silica dust workers was obtained through occupational health field investigation and detection, and the general situation of the study subjects was obtained through questionnaire survey and peripheral blood was collected. Double antigen sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of SP-D and CC16 in serum of workers. The mean values were compared by one-way ANOVA, and the influencing factors of SP-D and CC16 concentrations in serum were analyzed by ordered multiple logistic regression. Results: The time-weighted average concentration (C-TWA) of 174 workers exposed to silica dust (respirable dust) ranged from 0.09 mg/m(3)~3.58 mg/m(3), and the C-TWA overstandard rate of dust exposed workers was 32.18% (56/174) , with differences among workers in different positions (χ(2)=28.85, P<0.001) . The highest concentration of silica dust was (0.82±0.11) mg/m(3). Using C-TWA<50% OEL occupational exposure limit (OEL) as reference, serum SP-D concentration in workers with ≥50% OEL was increased (OR=4.95, 95%CI: 1.86~13.17, P=0.001) , while CC16 concentration was decreased (OR=0.15, 95%CI: 0.05~0.40, P<0.001) ; Serum CC16 concentration decreased in workers exposed to silica dust C-TWA≥OEL (OR=0.46, 95%CI: 0.28~0.98, P=0.043) . Compared with those with low occupational health literacy, the serum SP-D concentration of workers with high occupational health literacy decreased (OR=0.48, 95%CI: 0.25~0.92, P=0.027) and CC16 concentration increased (OR=2.09, 95%CI: 1.10-3.97, P=0.024) . Conclusion: When no abnormality was found in the physical examination of workers, the serum SP-D and CC16 concentration levels changed, and the change was related to the concentration of workers exposed to silica dust.

[Analysis of incidence characteristics and trend of pneumoconiosis in Ningbo City from 1967 to 2019].

Objective: To understand the incidence of pneumoconiosis in Ningbo city from 1967 to 2019, and to analyze the distribution characteristics and change trend of pneumoconiosis. Methods: In February 2021, the data of pneumoconiosis patients in Ningbo city from 1967 to 2019 were sorted out. The data from 1967 to 1987 were from historical case files of Zhejiang Center for Disease Control and Prevention, the data from 1988 to 2005 were from the historical case files of Ningbo Center for Disease Control and Prevention, and the data from 2006 to 2019 were from the pneumoconiosis report card in China Disease Prevention and Control Information System; Followed up and supplement relevant information, including basic information, basic information of employers and information related to pneumoconiosis diagnosis, and comprehensively analyze the composition and development trend, population characteristics and industry characteristics of pneumoconiosis. Results: From 1967 to 2019, a total of 1715 cases of pneumoconiosis were reported in Ningbo City, including 1254 cases of stageⅠpneumoconiosis, 258 cases of stageⅡpneumoconiosis, 172 cases of stage Ⅲpneumoconiosis. 1202 cases of silicosis (70.09%) , 296 cases of asbestosis (17.26%) , 40 cases of welder's pneumoconiosis (2.33%) , 32 cases of graphite pneumoconiosis (1.87%) were reported. There were 1296 male cases (75.57%) and 419 female cases (24.43%) were reported. Silicosis (91.15%, 1102/1209) and welder's pneumoconiosis (100.00%, 40/40) were the most common pneumoconiosis in males, while asbestosis (90.24%, 268/297) and graphite pneumoconiosis (87.50%, 28/32) were the most common pneumoconiosis in females. The average age was (49.71±10.90) years old and the average length of service was (10.98±6.96) years. The top three reported pneumoconiosis cases were construction industry (336 cases, 19.59%) , ferrous metal smelting and rolling industry (317 cases, 18.48%) and non-metallic mineral products industry (315 cases, 18.37%) . The top three reported pneumoconiosis cases were 414 cases (24.14%) in Ninghai County, 294 cases (17.14%) in Yuyao City and 272 cases (15.86%) in Yinzhou District. Conclusion: With the development of industries in Ningbo City, government departments should strengthen supervision and management of enterprises involving silica dust and welding fume to curb the high incidence of pneumoconiosis.

[Analysis of dust hazard characteristics in 59 ferrous metal foundry enterprises in Ningbo City].

Objective: To analyze the post distribution of dust concentration in ferrous metal foundry enterprises and evaluate the occupational health risks, and provide basis for policies of the formulation of pneumoconiosis prevention and control. Methods: From August to September in 2020, the basic information, dust hazard information and occupational health management information of 59 ferrous metal casting enterprises were investigated, the dust concentration distribution was analyzed, and the risk assessment was carried out by using the quantitative assignment model. The dust concentration is tested by LSD method after logarithmic treatment. The 3 times time weighted average allowable exposure concentration of dust is taken as the peak concentration limit of dust; The time weighted average allowable exposure concentration of dust converted by exposure time is taken as the time weighted average exposure concentration limit of dust, and whether the time weighted average exposure concentration and peak concentration of dust at the same post exceed the limit is taken as the basis for exceeding the limit of dust post concentration to calculate the post exceeding the limit rate. Results: The dust hazards were mainly distributed in the posts of sand treatment, molding, sand falling, sand cleaning and cutting and grinding. Dust exposure time weighted average concentration was 0.44 (0.03, 5.11) mg/m(3), peak exposure concentration was 1.30 (0.18, 10.94) mg/m(3), and the over standard rate of Posts was 38.92% (79/203) . Weighted average exposure concentration of other dust (total dust) in the cutting and grinding post is 1.50 (0.15, 7.40) mg/m(3), peak exposure concentration is 0.90 (0.07, 12.48) mg/m(3), and the post exceedance rate is 4.88% (2/41) . Weighted average exposure concentration of silica dust (exhaling dust) in dust operation posts of investment casting enterprises is 0.43 (0.05, 6.35) mg/m(3), peak exposure concentration is 0.90 (0.12, 8.28) mg/m(3), and the post over standard rate is 35.77% (49/137) ; Weighted average exposure concentration of other dust (total dust) at the cutting and grinding post is 2.00 (11.00, 21.00) mg/m(3), and the post exceedance rate is 2.50% (2/80) . There was no significant difference in the concentration of respirable dust between sand casting and investment casting (P>0.05) . The concentration of respirable dust in sand casting was higher than that in sand treatment, molding and sand cleaning posts (P<0.05) . The concentration of silica dust in investment casting was higher than that in sand treatment and molding posts, and that in sand cleaning posts was higher than that in sand treatment posts (P<0.05) . 98.48% (454/461) of the dust operation posts have an occupational health risk value greater than or equal to 400, and 1.52% (7/461) of the dust operation posts have an occupational health risk value of 200~399. Conclusion: there is a high rate of exceeding the standard in the dust work posts in the ferrous metal foundry enterprises in Ningbo, and the workers have a high occupational health risk of pneumoconiosis or metal and its compound pneumoconiosis. Targeted measures should be taken to reduce the occupational health risk.

[Occupational Health Risk Assessment of Low Concentrations Benzene Toluene and Xylenes].

Objective: To Assess occupational health risks of exposuring to low concentrations (lower than occupational exposure limit, OEL) benzene, toluene and Xylenes. Methods: Qualitative evaluation, semi-quantitative evaluation and quantitative evaluation from guidelines for occupational health risk assessment of chemicals in the workplace were conducted to assess occupational health risks exposure to benzene compounds in different workplaces of 5 manufacturing enterprises, respectively. Results: Concentrations of benzene, toluene and Xylenes in all workplaces were lower than OEL. Qualitative evaluation showed that occupational health risk level was 4 exposure to benzene and Xylenes in all workpalces, while 2 exposure to toluene. Semi-quantitative evaluation showed low level (2 of 5) risks in all workplaces exposured to benzene compounds excepted 4 workpalces exposured to benzene, the latter was moderate (3 of 5) . Quantitative evaluation gave unacceptable carcinogenic risk (higher than 10(-4)) of benzene in the wood toy manufactory, and the highest risk was (1.48~5.26) ×10(-4). The occupational health risks of benzene and Xylenes were all unacceptable (HQ>1) in 9 workplaces. Conclusion: There still need more attention to occupational health risks exposure to benzene, toluene and Xylenes lower than OEL.

[Analysis on occupational health surveillance to workers exposed to toxic environment in Ningbo].

Objective: To analyze the occupational health surveillance data of toxic and harmful workers in Ningbo, and provide scientific basis for making protective measures. Methods: To export the occupational health surveillance data of toxic and harmful workers reported by occupational health examination institutions in Ningbo during the January 1, 2011 to December 31, 2017 from the China Information System for Disease Control and Prevention, and analyze the trend of the suspected occupational disease and occupational contraindication detection rate, and compare the the health status of workers in different industry nature, economic type, enterprise scale and occupational hazards. Results: From 2011 to 2017, the number of occupational health surveillance of toxic and harmful workers in Ningbo was increasing year by year. The detection rates of suspected occupational diseases and occupational contraindications generally showed a downward trend (P<0.05) . In 2017, the distribution of occupational health care for toxic and harmful workers in Ningbo was mainly based on manufacturing (187 681/220 895, 84.96%) , private economic enterprises (103 960/220 895, 47.06%) and small enterprises (100 357/220 895, 45.43%) , Workers exposed to chemical poisons had the largest number of physical examinations (101 813/220 895, 46.09%) . The highest detection rates of suspected occupational diseases were mining industry (2/1225, 0.16%) , collective economic enterprises (4/2622, 0.15%) and small enterprises (88/100 357, 0.09%) . The highest detection rates of occupational contraindications were rental and business services (16/1 320, 1.21%) , private economic enterprises (1 190/103 960, 1.14%) and small enterprises (995/100 357, 0.99%) . In addition, workers exposed to dust had the highest detection rate of suspected occupational diseases (57/46 740, 0.12%) and workers exposed to physical factors had the highest detection rate of occupational contraindications (1207/69 567, 1.74%) . There were significant differences between the detection rate of suspected occupational disease and occupational contraindication in different industries, economic types, enterprise scale and occupational hazards (P<0.05) . Conclusion: The occupational health surveillance of toxic and harmful workers in Ningbo has been strengthened year by year, attention should be paid to small, private enterprises, and strengthen the supervision of occupational health and further standardize the work of occupational health examination so as to effectively protect the health of the occupational population.

[Analysis of acute pesticide poisoning in Ningbo city from 2011 to 2016].

Objective: To analyze the characteristics of acute pesticide poisoning in Ningbo, and to provide scientific basis for the prevention and control strategy. Methods: In February 2017, the pesticide poisoning report card of Ningbo from 2011 to 2016 was drawn from the China Disease Control and prevention information system. The data of the report card was organized by Excel and analyzed by SPSS19.0 software. Results: 2593 cases of acute pesticide poisoning were reported in Ningbo from 2011 to 2016, 125 deaths, and the case fatality rate was 4.82%. The productive pesticide poisoning and unproductive pesticide poisoning were 299 and 2294, respectively, the ratio was 1: 7.67. The case fatality rate were 0.33% and 5.41%, respectively. The difference was statistically significant (χ(2)=14.83, P<0.01). The productive Pesticide poisoning mainly occurred from July to September (55.85%) , the unproductive pesticides mainly occurred from April to June (30.64%) and July to September (30.34%). The seasonal distribution of the pesticide poisoning in the two groups was statistically significant (χ2=82.21, P<0.01). The productive pesticide poisoning in male (80.27%) was significantly higher than the proportion of unproductive pesticide poisoning (52.09%) , the differences in gender composition between the two types of pesticide poisoning was significant (χ2=84.97, P<0.01). The productive pesticide poisoning from 55 to 65 years old group was in the largest number (35.45%) , and the distribution of unproductive pesticide poisoning was uniform in each age group including 25 years old and above, the difference in age composition between two types of pesticide poisoning was statistically significant (χ2=177.84, P<0.01). All of the 10 counties of Ningbo had reports of pesticide poisoning. The counties with more reports were Ninghai county (18.28%) , Fenghua district (14.69%) and Yuyao (12.42%). The acute pesticide poisoning was mainly caused by pesticides and herbicides, mainly in organophosphorus (45.74%) and paraquat (16.81%) . Conclusions: At present, the pesticide poisoning in Ningbo is given priority to unproductive pesticide poisoning currently, seasonal distribution characteristics was obvious, and occurred both in different sex and age groups, suggesting that the relevant departments should carry out targeted health education, and strengthen the management of high toxic and highly toxic pesticides.

[Incidence and trend of occupational diseases in Ningbo, China, from 2006 to 2015].

Objective: To investigate the incidence, distribution features, and incidence trend of occupational diseases in Ningbo, China, from 2006 to 2015. Methods: In February 2016, the data on occupational disease report cards in the occupational disease and occupational health information system from 2006 to 2015 were collected to perform a comprehensive analysis of the types, incidence trend, population characteristics, and enterprise characteristics of occupational diseases. Results: There were 845 new cases of occupational diseases in Ningbo from 2006 to 2015, among which 596 (70.53%) were pneumoconiosis; there were 445 (74.66%) cases of stage I pneumoconiosis, 73 (12.25%) cases of stage II pneumoconiosis, and 78 (13.09%) cases of stage III pneumoconiosis; silicosis (59.76%) was the most common type of pneumoconiosis. Of all patients with occupational diseases, 84.97% were male, 64.50%were aged 35-55 years, and 63.67% had 5-20 working years. Most of the patients with occupational diseases worked in small and medium-sized private (or foreign) enterprises; the most common industries were black metal smelting and rolling (38.76%) , construction (17.11%) , and non-metallic ore mining (13.09%) . A total of 51.28%, 10.26%, and 7.69% of the patients with occupational poisoning worked in the electric apparatus manufacturing industry, furniture manufacturing industry, and chemical raw material and chemical product manufacturing industry, respectively. The cases of occupational diseases are mainly distributed in Yuyao City (24.62%) , Yinzhou District (23.91%) , and Ninghai County (15.62%) . Conclusion: Pneumoconiosis is the most common type of occupational disease in Ningbo and most of these patients work in small and medium-sized private (or foreign) enterprises. The supervision of small and medium-sized private enterprises should be enhanced to protect workers' health.

[The application of two occupation health risk assessment models in a wooden furniture manufacturing industry].

Objective: To explore the applicability of 2 different models of occupational health risk assessment in wooden furniture manufacturing industry. Methods: American EPA inhalation risk model and ICMM model of occupational health risk assessment were conducted to assess occupational health risk in a small wooden furniture enterprises, respectively. Results: There was poor protective measure and equipment of occupational disease in the plant. The concentration of wood dust in the air of two workshops was over occupational exposure limit (OEL) , and the CTWA was 8.9 mg/m3 and 3.6 mg/m3, respectively. According to EPA model, the workers who exposed to benzene in this plant had high risk (9.7×10-6 ~34.3×10-6) of leukemia, and who exposed to formaldehyde had high risk (11.4 × 10-6) of squamous cell carcinoma. There were inconsistent evaluation results using the ICMM tools of standard-based matrix and calculated risk rating. There were very high risks to be attacked by rhinocarcinoma of the workers who exposed to wood dust for the tool of calculated risk rating, while high risk for the tool of standard-based matrix. For the workers who exposed to noise, risk of noise-induced deafness was unacceptable and medium risk using two tools, respectively. Conclusion: Both EPA model and ICMM model can appropriately predict and assessthe occupational health risk in wooden furniture manufactory, ICMM due to the relatively simple operation, easy evaluation parameters, assessment of occupational- disease-inductive factors comprehensively, and more suitable for wooden furniture production enterprise.

Silencing effect of lentiviral vectors encod-ing shRNA of Herp on endoplasmic reticulum stress and inflammatory responses in RAW 264.7 macrophages.

Herp, a mammalian protein with a ubiquitin-like domain, can be strongly upregulated by endoplasmic reticulum (ER) stress during ER-associated protein degradation. However, the other cellular functions of Herp remain unclear. We explored the effect of Herp on ER stress and inflammatory responses in RAW 264.7 macrophages that had been exposed to tunicamycin or thapsigargin. We successfully constructed recombinant lentiviral vectors for Herp short-hairpin RNA (shRNA) expression to better understand the contribution made by Herp to other signaling pathways. Western blotting revealed that the recombinant Herp lentiviral shRNA vector significantly inhibited the expression of the Herp protein in the thapsigargin-treated RAW 264.7 macrophages. The reverse transcription quantitative polymerase chain reaction results showed that knockdown Herp inhibited the expression of ER stress-related genes during exposure to tunicamycin or thapsigargin. In RAW 264.7 macrophages, knockdown Herp markedly attenuated the expression of inflammatory cytokines when exposed to tunicamycin; however, it strongly enhanced the expression of inflammatory cytokines when exposed to thapsigargin. We concluded that Herp lentiviral shRNA vectors had been successfully constructed; knockdown Herp inhibited ER stress and had a different effect on inflammatory responses in RAW 264.7 macrophages depending on whether they were exposed to tunicamycin or thapsigargin.

Significance of combined detection of p53 and FHIT in cervical carcinoma diagnosis.

PURPOSE: To explore the significance of combined detection of p53 genes and fragile histidine triad (FHIT) genes in cervical carcinoma. MATERIALS AND METHODS: Specimens taken from 161 cases invasive carcinoma, 23 cases carcinoma in situ or cervical intraepithelial neoplasia III (CIN III), 74 cases CIN I - II, 25 cases normal cervical tissue, and 32 cases tumor-adjacent tissues were processed by immunohistochemistry to determine the expression of p53 and FHIT genes. The results of the combined detection were compared for clinical diagnostic value of cervical carcinoma diagnosis. RESULTS: The p53 gene, FHIT gene and the two genes combined examination of cervical carcinoma diagnostic sensitivity were: 65.8% (121/184), 66.3% (122/184), 90.2% (166/184), respectively. There were no significant differences between the p53 gene and the FHIT gene detected (p > 0.05). Combined detection of the two gene were more sensitivity than single detection, the difference was significant (p < 0.001). Although diagnosis specificity had dropped somewhat, no significant statistical appeared (chi2 = 0.022, p > 0.05). CONCLUSION: Combined detection of p53 genes and FHIT genes can increase the sensitivity diagnosis and specificity diagnosis for early cervical carcinoma and precancerous lesions has a positive meaning.

Normal evolution of pregnancy complicated by a giant placental chorioangioma.

Placental chorioangioma is a benign vascular tumour of placental origin. Here The authors report a case of a pregnant patient who presented placental chorioangioma measuring 11 cm in the greatest diameter at 37 weeks at term and in labor.

Intake of coffee, caffeine and other methylxanthines and risk of Type I vs Type II endometrial cancer.

BACKGROUND: Coffee and other sources of methylxanthines and risk of Type I vs Type II endometrial cancer (EC) have not been evaluated previously. METHODS: Prospective cohort of 23,356 postmenopausal women with 471 Type I and 71 Type II EC cases. RESULTS: Type I EC was statistically significantly associated with caffeinated (relative risk (RR)=0.65 for 4+ cups per day vs ≤1 cup per month: 95% confidence interval (CI): 0.47-0.89) but not decaffeinated (RR=0.76; 95% CI: 0.50-1.15) coffee intake; there were no associations with tea, cola or chocolate, or for Type II EC. The inverse association with caffeinated coffee intake was specific to women with a body mass index 30+ kg m(-2) (RR=0.56; 95% CI: 0.36-0.89). CONCLUSION: Coffee may protect against Type I EC in obese postmenopausal women.

[Transmission chains of local epidemic of COVID-19 caused by 2019-nCoV Delta variant in Zhenhai district, Ningbo].

Objective: To investigate the local epidemic of COVID-19 caused by 2019-nCoV Delta variant in Zhenhai district of Ningbo, identify the transmission chain and provide reference for the prevention and control of COVID-19 epidemic. Methods: The incidence data of COVID-19 in Zhenhai from 6 to 18 December, 2021 were collected in field investigation. Field epidemiological investigation was conducted to understand the epidemiological characteristics of COVID-19 cases and analyze the transmission chains. Results: The first case might be infected with 2019-nCoV through direct or indirect exposure when passing through a medium-risk area, then a family cluster was caused, and the epidemic spread through close contacts of family members with others such as work, daily life, and moxibustion. The epidemic lasted for 14 days, and 74 confirmed COVID-19 cases were reported. The median incubation period was 4.0(3.0,5.8)d. All the cases were in a chain of transmission for more than 6 generations, and the intergenerational interval was 3.5(2.0,5.3)d. The gene sequencing result indicated that the pathogen was Delta AY.4 variant of 2019-nCoV. Both the epidemiological investigation and the gene sequencing results supported that the local COVID-19 epidemic in Zhenhai was associated with the COVID-19 epidemic in Shanghai. Conclusions: The transmission chain of this epidemic was clear. Delta AY.4 variant has obvious characteristic to cause case clusters in families, places with poor ventilation, and residential communities. It is suggested to strengthen the health management in key areas and key populations, and increase the frequency of nucleic acid testing.

[Epidemiological characteristics of a local cluster epidemic caused by 2019-nCoV Delta variant in Ningbo, 2021].

Objective: To understand the epidemiological characteristics of a local clustered epidemic caused by 2019-nCoV Delta variant in Ningbo and provide reference for the improvement of COVID-19 epidemic prevention and control. Methods: Case finding was conducted based on case definitions, and field epidemiological investigation of COVID-19 cases was carried out. In which Nasal and oropharyngeal swabs of the cases were collected for pathogen testing, and the results were analyzed with descriptive epidemiological methods. Results: A total of 74 COVID-19 cases were reported in this epidemic, and the cases were mainly mild ones, accounting for 87.84% (65/74), and there were no severe or critical cases. The epidemic curve showed a human-to-human transmission mode, indicating that a transmission for at least six generations had occurred. The age of the COVID-19 patients ranged from 2 years to 80 years, and 27.03% (20/74) of the cases were older than 60 years. The cases were mainly workers (55.41%, 41/74) and housework/the unemployed (27.03%, 20/74). The COVID-19 epidemic was limited, and no further spread to other areas occurred. The transmission chain among the cases was clear, and the gene sequencing results confirmed that the current epidemic was caused by 2019-nCoV Delta variant, which was highly homologous to the strains from other province. Conclusion: The local COVID-19 epidemic in Ningbo was caused by imported cases of COVID-19 from other province, and local community spread occurred through daily contacts between cases and contacts.

Dietary and supplemental intake of one-carbon nutrients and the risk of type I and type II endometrial cancer: a prospective cohort study.

BACKGROUND: Type I and II endometrial cancer are biologically and clinically distinct, with type II cancers having a high frequency of p53 mutations and an association with chromosomal instability. This raises the hypothesis that one-carbon nutrients (folate, methionine, and the enzymic cofactors vitamins B2, B6, and B12), which mediate chromosomal stability and DNA methylation, may be protective for type II but not type I endometrial cancer. METHODS: Using a prospective cohort of 23 356 postmenopausal women followed 20 years, we estimated the relative risks (RRs) of type I (N = 471) and II (N = 71) endometrial cancers according to intake of one-carbon nutrients, adjusting for confounders. RESULTS: No associations were observed between dietary or supplemental intake of any one-carbon nutrient and risk of type I cancer. For type II cancer, positive associations were due to supplemental, rather than dietary, intake of these nutrients: supplemental folate (RR = 1.80 for >228.6 versus 0 µg/day; P trend = 0.027) and vitamins B2 (RR = 1.94 for >1.70 versus 0 mg/day; P trend = 0.011), B6 (RR = 2.08 for >2.00 versus 0 mg/day; P trend = 0.012), and B12 (RR = 2.10 for >3.43 versus 0 µg/day; P trend = 0.0060). CONCLUSION: Contrary to our hypothesis, use of supplements containing folate and vitamins B2, B6, and B12 was associated with an increased risk of type II endometrial cancer.

Characterization of yeasts colonizing in healthy individuals.

Opportunistic yeast pathogens may switch from harmless commensal to pathogenic relationships with the host under different conditions. They usually cause superficial infections, but may be the agents of more significant infections in immunocompromised patients. To investigate yeast colonization in the oral cavities of clinically healthy individuals, we collected oral swabs from 323 students and staff at the National Health Research Institutes, Taiwan. A total of 49 (15.2%) volunteers were colonized by low levels of yeasts and of these, only 3 (6.1%) were co-colonized by more than one species. Among the 52 isolates, comprising seven fungal genera and 13 species, Candida albicans (57.7%) was the dominant species, followed by Candida parapsilosis (15.4%). There was only one isolate of C. parapsilosis that showed, in vitro, a high (2 µg/ml) minimum inhibitory concentration (MIC) to amphotericin B. There were six (11.5%) isolates with fluconazole MICs ≥ 64 µg/ml and all of them were non-Candida species. With the exception of Cryptococcus albidus, the remaining five isolates had voriconazole MICs ≥ 4 µg/ml. In addition, there was one C. albicans isolate with relatively high fluconazole (32 µg/ml) and voriconazole (4 µg/ml) MICs.

[Prevalence and associated factors for malnutrition among children under 6 years of age in Hunan province].

Objective: To analyze the prevalence and associated factors of malnutrition among children under 6 years of age in Hunan province. Methods: This study was a cross-sectional study. A combination of multistage stratified cluster sampling and systematic sampling approach was used to recruit 10 442 children aged 0-71 months from 144 communities (villages) across 48 streets(towns) in 24 districts(counties) from Hunan province between August and November 2019. Data concerning the children and their mothers, caregivers, and family conditions was collected using unified questionnaire, with the lengths/heights and weights of the children being measured using unified instruments. The length/height for age, weight for age, weight for length/height, and body mass index for age Z scores were calculated and used to evaluate the prevalence of children's stunting, underweight, and wasting. The chi-square test was used to compare the prevalence of malnutrition among children with different characteristics. The multivariate Logistic regression model was used to conduct multivariate analysis for childrens' malnutrition. Results: The prevalence of protein-energy malnutrition (PEM) among children under 6 years of age was 6.8% (710/10 442), and the prevalence of stunting, underweight, and wasting were 3.1% (328/10 442), 2.7% (280/10 442), and 3.3% (343/10 442), respectively. Rural areas (OR=1.60), older age of children (compared with children of 0-11 months, the OR for 12-23, 24-35, 36-47, 48-59, and 60-71 months were 1.42, 1.75, 1.55, 1.70, and 1.88, respectively), low birth weight (OR=2.72), caregivers of minority ethnicity (OR=1.95), and large family size (OR=1.25) were risk factors for children's PEM. Rural areas and low birth weight were risk factors for stunting in children (OR=2.13 and 3.28). Rural areas, low birth weight, caregivers of minority ethnicity, and large family size were risk factors for underweight in children (OR=2.57, 3.34, 1.86, and 1.32). Rural areas (OR=1.43), older age of children (compared with children of 0-11 months, the OR for 24-35, 36-47, 48-59, and 60-71 months were 1.63, 1.80, 1.84 and 2.17, respectively), low birth weight (OR=2.36), caregivers of minority ethnicity (OR=2.88), and large family size (OR=1.42) were risk factors for children's wasting. Higher education level of caregivers was a common protective factor for PEM, stunting, and underweight (OR=0.85, 0.76, and 0.82). Conclusions: The prevalence of stunting, underweight, and wasting among children under 6 years of age in Hunan province were all at a low level. Nevertheless, the urban-rural differences still existed, with these prevalence being affected by children age, birth weight, ethnicity of caregivers, education level, and family size.

The distribution of species and susceptibility of amphotericin B and fluconazole of yeast pathogens isolated from sterile sites in Taiwan.

To study the demographic changes of yeasts causing invasive infections in Taiwan, especially with respect to species distribution and antifungal susceptibility, we analyzed isolates obtained from four sterile sites of patients in 19 hospitals in 2002 (155 strains) and again from the same hospitals in 2006 (208 strains). Blood was the most common source of the yeasts, accounting for 73.8% of the total isolates, followed by ascites (21.5%), cerebrospinal fluid (3%), and synovia (1.7%). Candida albicans was the most frequently recovered species (50.1% of the total), followed by Candida tropicalis (20.7%), Candida glabrata (11.6%), Candida parapsilosis (8.5%), Cryptococcus neoformans (3.9%), Candida krusei (0.8%), and nine other species (4.3%). There were one (0.3%) and seven (1.9%) isolates with minimum inhibitory concentrations (MICs) of amphotericin B > or =2 mg/l after 24 h and 48 h incubation, respectively. In addition, there were 15 (4.3%) and 31 (8.6%) isolates with MICs of fluconazole > or =64 mg/l under the same conditions. The MIC(90) value of amphotericin B was 1 mg/l. The MIC(90) values of fluconazole were 4 mg/l after 24 h incubation and 32 mg/l after 48 h incubation. Interestingly, MICs for fluconazole > or =64 mg/l after 24 h were significantly higher for isolates obtained in 2006 than those in 2002 after 24 h (7.1% vs. 0.7%, p =0.009) and 48 h (13.5% vs. 2%, p =0.0003) incubations. The demographic difference between these two surveys is mainly due to one species, C. tropicalis.